Nonprofits

Design Thinking for Social Innovation

Designers have traditionally focused on enhancing the look and functionality of products. Recently, they have begun using design techniques to tackle more complex problems, such as finding ways to provide low-cost healthcare throughout the world. Businesses were the first to embrace this new approach—called design thinking—and nonprofits are beginning to adopt it too.

In an area outside Hyderabad, India, between the suburbs and the countryside, a young
woman—we’ll call her Shanti—fetches water daily from the always-open local borehole that is
about 300 feet from her home. She uses a 3-gallon plastic container that she can easily carry on
her head. Shanti and her husband rely on the free water for their drinking and washing, and though
they’ve heard that it’s not as safe as water from the Naandi Foundation-run community treatment
plant, they still use it. Shanti’s family has been drinking the local water for generations, and although
it periodically makes her and her family sick, she has no plans to stop using it.

Shanti has many reasons not to use the water from the Naandi treatment center, but they’re not
the reasons one might think. The center is within easy walking distance of her home—roughly a
third of a mile. It is also well
known and affordable (roughly
10 rupees, or 20 cents, for 5
gallons). Being able to pay the
small fee has even become a
status symbol for some villagers.
Habit isn’t a factor, either.
Shanti is forgoing the safer
water because of a series of
flaws in the overall design of
the system.

Although Shanti can walk
to the facility, she can’t carry
the 5-gallon jerrican that the facility
requires her to use. When
filled with water, the plastic
rectangular container is simply
too heavy. The container
isn’t designed to be held on the
hip or the head, where she likes
to carry heavy objects. Shanti’s
husband can’t help carry it, either.
He works in the city and
doesn’t return home until after
the water treatment center is
closed. The treatment center
also requires them to buy a
monthly punch card for 5 gallons
a day, far more than they
need. “Why would I buy more
than I need and waste money?”
asks Shanti, adding she’d be
more likely to purchase the
Naandi water if the center allowed
her to buy less.

The community treatment
center was designed to produce
clean and potable water,
and it succeeded very well at
doing just that. In fact, it works
well for many people living
in the community, particularly
families with husbands
or older sons who own bikes
and can visit the treatment plant during working hours. The designers of the center, however,
missed the opportunity to design an even better system because
they failed to consider the culture and needs of all of the people
living in the community.

This missed opportunity, although an obvious omission in hindsight,
is all too common. Time and again, initiatives falter because
they are not based on the client’s or customer’s needs and have never
been prototyped to solicit feedback. Even when people do go into the
field, they may enter with preconceived notions of what the needs
and solutions are. This flawed approach remains the norm in both
the business and social sectors.

As Shanti’s situation shows, social challenges require systemic
solutions that are grounded in the client’s or customer’s needs. This
is where many approaches founder, but it is where design thinking—a new approach to creating solutions—excels.

Traditionally, designers focused their attention on improving the
look and functionality of products. Classic examples of this type of
design work are Apple Computer’s iPod and Herman Miller’s Aeron
chair. In recent years designers have broadened their approach, creating
entire systems to deliver products and services.

Design thinking incorporates constituent or consumer insights
in depth and rapid prototyping, all aimed at getting beyond the
assumptions that block effective solutions. Design thinking—inherently
optimistic, constructive, and experiential—addresses the
needs of the people who will consume a product or service and the
infrastructure that enables it.

Businesses are embracing design thinking because it helps them
be more innovative, better differentiate their brands, and bring their
products and services to market faster. Nonprofits are beginning to
use design thinking as well to develop better solutions to social problems.
Design thinking crosses the traditional boundaries between
public, for-profit, and nonprofit sectors. By working closely with the
clients and consumers, design thinking allows high-impact solutions
to bubble up from below rather than being imposed from the top.

Design Thinking at Work

Jerry Sternin, founder of the Positive Deviance Initiative and an associate professor at Tufts University until he died last year, was skilled at identifying what and critical of what he called outsider solutions to local problems. Sternin’s preferred approach to social innovation is an example of design thinking in action.1 In 1990, Sternin and his wife, Monique, were invited by the government of Vietnam to develop a model to decrease in a sustainable manner high levels of malnutrition among children in 10,000 villages. At the time, 65 percent of Vietnamese children under age 5 suffered from malnutrition, and most solutions relied on government and UN agencies donations of nutritional supplements. But the supplements—the outsider solution—never delivered the hoped-for results.2 As an alternative, the Sternins used an approach called positive deviance, which looks for existing solutions (hence sustainable) among individuals and families in the community who are already doing well.3

The Sternins and colleagues from Save the Children surveyed
four local Quong Xuong communities in the province of Than Hoa
and asked for examples of “very, very poor” families whose children
were healthy. They then observed the food preparation, cooking,
and serving behaviors of these six families, called “positive deviants,”
and found a few consistent yet rare behaviors. Parents of
well-nourished children collected tiny shrimps, crabs, and snails
from rice paddies and added them to the food, along with the greens
from sweet potatoes. Although these foods were readily available,
they were typically not eaten because they were considered unsafe
for children. The positive deviants also fed their children multiple
smaller meals, which allowed small stomachs to hold and digest
more food each day.

The Sternins and the rest of their group worked with the positive
deviants to offer cooking
classes to the families
of children suffering from
malnutrition. By the end
of the program’s first year,
80 percent of the 1,000
children enrolled in the
program were adequately
nourished. In addition, the
effort had been replicated
within 14 villages across
Vietnam.4

The Sternins’ work is a
good example of how positive
deviance and design
thinking relies on local
expertise to uncover local
solutions. Design thinkers
look for work-arounds and
improvise solutions—like
the shrimps, crabs, and
snails—and they find ways
to incorporate those into the offerings they create. They consider
what we call the edges, the places where “extreme” people live differently,
think differently, and consume differently. As Monique
Sternin, now director of the Positive Deviance Initiative, explains:
“Both positive deviance and design thinking are human-centered approaches.
Their solutions are relevant to a unique cultural context
and will not necessarily work outside that specific situation.”

One program that might have benefited from design thinking
is mosquito net distribution in Africa. The nets are well designed
and when used are effective at reducing the incidence of malaria.5
The World Health Organization praised the nets, crediting them
with significant drops in malaria deaths in children under age 5: a
51 percent decline in Ethiopia, 34 percent decline in Ghana, and 66
percent decline in Rwanda.6 The way that the mosquito nets have
been distributed, however, has had unintended consequences.
In northern Ghana, for instance, nets are provided free to pregnant
women and mothers with children under age 5. These women
can readily pick up free nets from local public hospitals. For everyone
else, however, the nets are difficult to obtain. When we asked a well-educated Ghanaian named Albert, who had recently contracted
malaria, whether he slept under a mosquito net, he told us no—there
was no place in the city of Tamale to purchase one. Because so many
people can obtain free nets, it is not profitable for shop owners to sell
them. But hospitals are not equipped to sell additional nets, either.

As Albert’s experience shows, it’s critical that the people designing
a program consider not only form and function, but distribution
channels as well. One could say that the free nets were never intended
for people like Albert—that he was simply out of the scope of
the project. But that would be missing a huge opportunity. Without
considering the whole system, the nets cannot be widely distributed,
which makes the eradication of malaria impossible.

The Origin of Design Thinking

IDEO was formed in 1991 as a merger between David Kelley Design,
which created Apple Computer’s first mouse in 1982, and ID Two,
which designed the first laptop computer, also in 1982. Initially, IDEO
focused on traditional design work for business, designing products
like the Palm V personal digital assistant, Oral-B toothbrushes, and
Steelcase chairs. These are the types of objects that are displayed in
lifestyle magazines or on pedestals in modern art museums.

By 2001, IDEO was increasingly being asked to tackle problems
that seemed far afield from traditional design. A healthcare foundation
asked us to help restructure its organization, a century-old
manufacturing company wanted to better understand its clients, and
a university hoped to create alternative learning environments to
traditional classrooms. This type of work took IDEO from designing
consumer products to designing consumer experiences.

To distinguish this new type of design work, we began referring
to it as “design with a small d.” But this phrase never seemed fully
satisfactory. David Kelley, also the founder of Stanford University’s
Hasso Plattner Institute of Design (aka the “d.school”), remarked
that every time someone asked him about design, he found himself
inserting the word “thinking” to explain what it was that designers
do. Eventually, the term design thinking stuck.7

As an approach, design thinking taps into capacities we all have
but that are overlooked by more conventional problem-solving practices.
Not only does it focus on creating products and services that are
human centered, but the process itself is also deeply human. Design
thinking relies on our ability to be intuitive, to recognize patterns,
to construct ideas that have emotional meaning as well as being
functional, and to express ourselves in media other than words or
symbols. Nobody wants to run an organization on feeling, intuition,
and inspiration, but an over-reliance on the rational and the analytical
can be just as risky. Design thinking, the integrated approach at
the core of the design process, provides a third way.

The design thinking process is best thought of as a system of
overlapping spaces rather than a sequence of orderly steps. There
are three spaces to keep in mind: inspiration, ideation, and implementation.
Think of inspiration as the problem or opportunity that
motivates the search for solutions; ideation as the process of generating,
developing, and testing ideas; and implementation as the path
that leads from the project stage into people’s lives.

The reason to call these spaces, rather than steps, is that they
are not always undertaken sequentially. Projects may loop back
through inspiration, ideation, and implementation more than once
as the team refines its ideas and explores new directions. Not surprisingly,
design thinking can feel chaotic to those doing it for the
first time. But over the life of a project, participants come to see that
the process makes sense and achieves results, even though its form
differs from the linear, milestone-based processes that organizations
typically undertake.

Inspiration

Although it is true that designers do not always proceed through
each of the three spaces in linear fashion, it is generally the case
that the design process begins with the inspiration space—the problem
or opportunity that motivates people to search for solutions.
And the classic starting point for the inspiration phase is the brief.
The brief is a set of mental constraints that gives the project team
a framework from which to begin, benchmarks by which they can
measure progress, and a set of objectives to be realized—such as
price point, available technology, and market segment.

But just as a hypothesis is not the same as an algorithm, the brief
is not a set of instructions or an attempt to answer the question before
it has been posed. Rather, a well-constructed brief allows for
serendipity, unpredictability, and the capricious whims of fate—the
creative realm from which breakthrough ideas emerge. Too abstract
and the brief risks leaving the project team wandering; too narrow
a set of constraints almost guarantees that the outcome will be incremental
and, likely, mediocre.

Once the brief has been constructed, it is time for the design
team to discover what people’s needs are. Traditional ways of doing
this, such as focus groups and surveys, rarely yield important
insights. In most cases, these techniques simply ask people what
they want. Conventional research can be useful in pointing toward
incremental improvements, but those don’t usually lead to the type
of breakthroughs that leave us scratching our heads and wondering
why nobody ever thought of that before.

Henry Ford understood this when he said, “If I’d asked my customers
what they wanted, they’d have said ‘a faster horse.’” 8 Although
people often can’t tell us what their needs are, their actual
behaviors can provide us with invaluable clues about their range
of unmet needs.

A better starting point is for designers to go out into the world
and observe the actual experiences of smallholder farmers, schoolchildren,
and community health workers as they improvise their way
through their daily lives. Working with local partners who serve as
interpreters and cultural guides is also important, as well as having
partners make introductions to communities, helping build credibility
quickly and ensuring understanding. Through “homestays” and
shadowing locals at their jobs and in their homes, design thinkers
become embedded in the lives of the people they are designing for.

Earlier this year, Kara Pecknold, a student at Emily Carr University
of Art and Design in Vancouver, British Columbia, took an internship
with a women’s cooperative in Rwanda. Her task was to develop a Web
site to connect rural Rwandan weavers with the world. Pecknold soon
discovered that the weavers had little or no access to computers and
the Internet. Rather than ask them to maintain a Web site, she reframed
the brief, broadening it to ask what services could be provided to the community to help them improve their
livelihoods. Pecknold used various design
thinking techniques, drawing partly from
her training and partly from ideo’s Human
Centered Design toolkit, to understand the
women’s aspirations.

Because Pecknold didn’t speak the women’s
language, she asked them to document
their lives and aspirations with a camera and
draw pictures that expressed what success
looked like in their community. Through
these activities, the women were able to
see for themselves what was important and
valuable, rather than having an outsider make those assumptions for
them. During the project, Pecknold also provided each participant
with the equivalent of a day’s wages (500 francs, or roughly $1) to
see what each person did with the money. Doing this gave her further
insight into the people’s lives and aspirations. Meanwhile, the
women found that a mere 500 francs a day could be a significant, life-changing
sum. This visualization process helped both Pecknold and
the women prioritize their planning for the community.9

Ideation

The second space of the design thinking process is ideation. After
spending time in the field observing and doing design research, a
team goes through a process of synthesis in which they distill what
they saw and heard into insights that can lead to solutions or opportunities
for change. This approach helps multiply options to create
choices and different insights about human behavior. These might
be alternative visions of new product offerings, or choices among
various ways of creating interactive experiences. By testing competing
ideas against one another, the likelihood that the outcome
will be bolder and more compelling increases.

As Linus Pauling, scientist and two-time Nobel Prize winner, put
it, “To have a good idea you must first have lots of ideas.” 10 Truly
innovative ideas challenge the status quo and stand out from the
crowd—they’re creatively disruptive. They provide a wholly new
solution to a problem many people didn’t know they had.

Of course, more choices mean more complexity, which can make
life difficult, especially for those whose job it is to control budgets
and monitor timelines. The natural tendency of most organizations
is to restrict choices in favor of the obvious and the incremental. Although
this tendency may be more efficient in the short run, it tends
to make an organization conservative and inflexible in the long run.
Divergent thinking is the route, not the obstacle, to innovation.

To achieve divergent thinking, it is important to have a diverse
group of people involved in the process. Multidisciplinary people—architects who have studied psychology, artists with MBAs, or engineers
with marketing experience—often demonstrate this quality.
They’re people with the capacity and the disposition for collaboration
across disciplines.

To operate within an interdisciplinary environment, an individual
needs to have strengths in two dimensions—the “T-shaped” person.
On the vertical axis, every member of the team needs to possess a
depth of skill that allows him or her to make tangible contributions to
the outcome. The top of the “T” is where the design thinker is made.
It’s about empathy for people and for disciplines beyond one’s own. It
tends to be expressed as openness, curiosity, optimism, a tendency
toward learning through doing, and experimentation. (These are the
same traits that we seek in our new hires at IDEO.)

Interdisciplinary teams typically move into a structured brainstorming
process. Taking one provocative question at a time, the
group may generate hundreds of ideas ranging from the absurd to
the obvious. Each idea can be written on a Post-it note and shared
with the team. Visual representations of concepts are encouraged,
as this generally helps others understand complex ideas.

One rule during the brainstorming process is to defer judgment.
It is important to discourage anyone taking on the often obstructive,
non-generative role of devil’s advocate, as Tom Kelley explains
in his book The Ten Faces of Innovation.11 Instead, participants are
encouraged to come up with as many ideas as possible. This lets the
group move into a process of grouping and sorting ideas. Good ideas
naturally rise to the top, whereas the bad ones drop off early on.
InnoCentive provides a good example of how design thinking
can result in hundreds of ideas. InnoCentive has created a Web site
that allows people to post solutions to challenges that are defined
by InnoCentive members, a mix of nonprofits and companies. More
than 175,000 people—including scientists, engineers, and designers
from around the world—have posted solutions.

The Rockefeller Foundation has supported 10 social innovation
challenges through InnoCentive and reports an 80 percent success
rate in delivering effective solutions to the nonprofits posting challenges.
12 The open innovation approach is effective in producing
lots of new ideas. The responsibility for filtering through the ideas,
field-testing them, iterating, and taking them to market ultimately
falls to the implementer.

An InnoCentive partnership with the Global Alliance for TB Drug
Development sought a theoretical solution to simplify the current TB
treatment regimen. “The process is a prime example of design thinking
contributing to social innovation,” explained Dwayne Spradlin,
InnoCentive’s CEO. “With the TB drug development, the winning
solver was a scientist by profession, but submitted to the challenge
because his mother—the sole income provider for the family—developed
TB when he was 14. She had to stop working, and he took on the
responsibility of working and going to school to provide for the family.” Spradlin finds that projects within the InnoCentive community often
benefit from such deep and motivating connections.13

Implementation

The third space of the design thinking process is implementation,
when the best ideas generated during ideation are turned into a
concrete, fully conceived action plan. At the core of the implementation
process is prototyping, turning ideas into actual products and
services that are then tested, iterated, and refined.

Through prototyping, the design thinking process seeks to uncover
unforeseen implementation challenges and unintended consequences
in order to have more reliable long-term success. Prototyping
is particularly important for products and services destined for
the developing world, where the lack of infrastructure, retail chains,
communication networks, literacy, and other essential pieces of the
system often make it difficult to design new products and services.

Prototyping can validate a component of a device, the graphics
on a screen, or a detail in the interaction between a blood donor and
a Red Cross volunteer. The prototypes at this point may be expensive,
complex, and even indistinguishable from the real thing. As the
project nears completion and heads toward real-world implementation,
prototypes will likely become more complete.

After the prototyping process is finished and the ultimate product
or service has been created, the design team helps create a communication
strategy. Storytelling, particularly through multimedia,
helps communicate the solution to a diverse set of stakeholders inside
and outside of the organization, particularly across language
and cultural barriers.

VisionSpring, a low-cost eye care provider in India, provides a
good example of how prototyping can be a critical step in implementation.
VisionSpring, which had been selling reading glasses to
adults, wanted to begin providing comprehensive eye care to children.
VisionSpring’s design effort included everything other than the
design of the glasses, from marketing “eye camps” through self-help
groups to training teachers about the importance of eye care and
transporting kids to the local eye care center.

Working with VisionSpring, IDEO designers prototyped the eyescreening
process with a group of 15 children between the ages of
8 and 12. The designers first tried to screen a young girl’s vision
through traditional tests. Immediately, though, she burst into tears—the pressure of the experience was too great and the risk of failure
too high. In hopes of diffusing this stressful situation, the designers
asked the children’s teacher to screen the next student. Again,
the child started to cry. The designers then asked the girl to screen
her teacher. She took the task very seriously, while her classmates
looked on enviously. Finally, the designers had the children screen
each other and talk about the process. They loved playing doctor
and both respected and complied with the process.

By prototyping and creating an implementation plan to pilot
and scale the project, IDEO was able to design a system for the eye
screenings that worked for VisionSpring’s practitioners, teachers,
and children. As of September 2009, VisionSpring had conducted
in India 10 eye camps for children, screened 3,000 children, transported
202 children to the local eye hospital, and provided glasses
for the 69 children who needed them.

“Screening and providing glasses to kids presents many unique problems,
so we turned to design thinking to provide us with an appropriate
structure to develop the most appropriate marketing and distribution
strategy,” explained Peter Eliassen, vice president of sales and operations
at VisionSpring. Eliassen added that prototyping let VisionSpring
focus on the approaches that put children at ease during the screening
process. “Now that we have become a design thinking organization, we
continue to use prototypes to assess the feedback and viability of new
market approaches from our most important customers: our vision
entrepreneurs [or salespeople] and end consumers.” 14

Systemic Problems Need Systemic Solutions

Many social enterprises already intuitively use some aspects of design
thinking, but most stop short of embracing the approach as a way to
move beyond today’s conventional problem solving. Certainly, there
are impediments to adopting design thinking in an organization. Perhaps
the approach isn’t embraced by the entire organization. Or maybe
the organization resists taking a human-centered approach and fails
to balance the perspectives of users, technology, and organizations.

One of the biggest impediments to adopting design thinking
is simply fear of failure. The notion that there is nothing wrong
with experimentation or failure, as long as they happen early and
act as a source of learning, can be difficult to accept. But a vibrant
design thinking culture will encourage prototyping—quick, cheap,
and dirty—as part of the creative process and not just as a way of
validating finished ideas.

As Yasmina Zaidman, director of knowledge and communications
at Acumen Fund, put it, “The businesses we invest in require
constant creativity and problem solving, so design thinking is a
real success factor for serving the base of the economic pyramid.”
Design thinking can lead to hundreds of ideas and, ultimately, real-world
solutions that create better outcomes for organizations and
the people they serve.

Tim Brown is the CEO and president of IDEO, a global innovation and design
firm. He is author of Change by Design: How Design Thinking Transforms Organizations
and Inspires Innovation (HarperBusiness, 2009), a newly published book
about how design thinking transforms organizations and inspires innovation.

Jocelyn Wyatt leads IDEO's Social Innovation group, which works with enterprises,
foundations, nongovernmental organizations, and multinationals to build
capabilities in design thinking and design innovative offerings that meet the needs
of local customers.